Provider Demographics
NPI:1396704177
Name:CARY, SANDRA L (LISW-CP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:CARY
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 STONEBROOK FARM WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6075
Mailing Address - Country:US
Mailing Address - Phone:864-288-7616
Mailing Address - Fax:864-288-0211
Practice Address - Street 1:203 STONEBROOK FARM WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6075
Practice Address - Country:US
Practice Address - Phone:864-288-7616
Practice Address - Fax:864-288-0211
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC51761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical